Healthcare Provider Details

I. General information

NPI: 1811869704
Provider Name (Legal Business Name): ALLY MCGILL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 W 109TH ST STE 200
OVERLAND PARK KS
66211-1354
US

IV. Provider business mailing address

5101 COLLEGE BLVD
LEAWOOD KS
66211-1614
US

V. Phone/Fax

Practice location:
  • Phone: 913-721-3387
  • Fax: 816-875-2597
Mailing address:
  • Phone: 913-721-3387
  • Fax: 816-875-2597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-84776-012
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025041685
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: